Health Blog

Tag Archives: Baylor Regional Medical Center

Post navigation

Already seen and unsuccessfully treated, she understandably was frustrated and came to us for a second opinion. Admittedly, I had no idea the cause for her unusual blotchy, blue, and cold rash. Its odd distribution was limited to her horse-rider’s saddle-seat, which made this rash exceptionally puzzling. It was not a bruise or an allergic reaction. It was “prickly,” but not itching. What in the world was going on here?

My usual medical go-to web sites and dermatology books were useless. I shamefully admit that I succumbed to a Google search for help. No answers.

Not one to waste time, I rushed to the phone and called Dr. Kendra Rorrie because she is brilliant. According to my dermatology friend, the history and rash were diagnostic of equestrian cold panniculitis. I never heard of it. She explained that the unusual condition is one that many dermatologists have studied, but most never see in clinical practice (or at least here in our usually warmer Texas winters).

Equestrian cold panniculitis is a result of prolonged cold exposure while seated in the saddle. Wet and cold weather (such as we are currently experiencing) can promote decreased blood flow and inflammation in the superficial fatty tissue of the thigh, buttocks and lower abdomen. In one study, four patients were young, healthy women equestrians who rode at least two hours daily. Their uninsulated tight-fitting riding pants slowed blood flow through exposed areas of the skin, causing small, red, itchy lesions on the upper and outer portions of both thighs. In some study patients, the rash became more severe and progressed to tender bumps and raised painful plaques. Fortunately, my patient’s condition was far less severe.

Cold panniculitis is not limited to horse riders. It has also been reported in cyclists, golf-cart riders, and milk-delivery men (they do exist in Finland!). In infants, the cold injury rash can be found on the cheeks and forehead…so keep those babies covered up!

My patient is a dedicated equestrian and regularly exercises seven horses daily. We compromised and I cleared her to return to riding but only with “prescribed “ breathable cotton long johns to wear under her riding pants. Today, I called to check on her. Unfortunately, she is not keeping her end of the bargain, but that is OK. As a former equestrian, I understand how difficult it can be to put anything under those tight riding pants! At least she now understands her medical condition and knows how to best manage her discomfort if her panniculitis worsens over the next few cold wintery days.

I love eggs. I especially love the center yolk. Do not expect me to share this perfectly round golden nugget with anyone because it is highly palatable. As far as the egg white, I usually give that to my kids or the dogs. My daughter insists the egg whites are healthier. Subsequently, she and I share our eggs. She eats the whites because they are “healthier” and I enjoy eating the delicious yolks. When it comes to eggs, my daughter and I are highly efficient eaters. This latest news may change my daughter’s mind about her yolk-aversion.

Much to everyone’s surprise, traditional dietary guidelines centered on decreasing dietary cholesterol are being debunked. Egg yolks are no longer considered a “nutrient of concern”. Other foods high in cholesterol such as shrimp and lobster are also being released from the bad-for-you food list; however, foods high in fats such as butter, heavy cream, and fatty foods remain under dietary restriction.

In a recent study, consumption of one egg daily did not increase the risk of heart disease. Even more promising, higher egg consumption was associated with a 25% reduction of stroke in one subset of study participants. In addition, previous studies found that increasing dietary cholesterol intake had very little impact in approximately 70% of people. In many people, high blood cholesterol levels are hereditary and may not be significantly affected by cholesterol-lowering diets. However there are other diets and lifestyle changes that can help to improve health.

Previous 2010 guidelines recommended cholesterol consumption less than 300mg per day. The average eggcontains approximately 200mg of cholesterol. Most omelets contain 2-3 eggs, which exceeds prior nutritional cholesterol recommendations. This doctor is not providing full medical clearance (yet) to binge on 2-3 egg omelets daily, but that may change if studies continue to support the egg’s healthy nutritional status. Be a responsible egg eater. Anything fried cannot be good for you!

To my family: You know all of our many refrigerated cartons of egg whites? Can we finally ditch those and have regular whole egg omelets? They taste much better and (in limited quantities) are just fine for healthy eating!

In the last few years, more and more states allow marijuana for both medical and recreational use. According to a review article from theJournal of the American Medical Association (JAMA) January 20, 2015; Colorado’s medical communities have experienced “unexpected health effects” from the widespread use of THC.

With increased availability of legal marijuana, the Colorado health system has experienced an increased number of severe burns. One Colorado hospital has seen a rise in marijuana-related burns with some cases involving more than 70% of the body surface area. Most burn injuries occurred due to butane which is a highly inflammable chemical used during extraction of marijuana’s active ingredient: tetrahydrocannabinol (THC) from marijuana plants.

Hospitals have also seen increased numbers of emergency room visits due to THC-related vomiting. At high concentrations and in people with THC-sensitivity, THC may cause severe abdominal pain, vomiting and profuse sweating; a condition known as cyclic vomiting syndrome.

Most concerning was the THC health effects among Colorado’s children. Numbers of children brought to the emergency room for unintentional marijuana ingestion are on the rise. For example: In this past year, of 14 children admitted to one Colorado community hospital this year for ingestion of edible marijuana products, 7 were placed in intensive care. For the 5 years preceding marijuana legalization, this community hospital had 0 similar admissions. These marijuana-related medical complications are new to most Colorado health communities.

In many states, marijuana has been legalized for medical purposes. My husband was surprised to learn that marijuana may offer significant medical benefits for some patients. Marijuana’s active ingredient, THC, has proven anti-inflammatory effects for people with significant bowel diseases and may reduce the incidence of seizures in others. Marijuana is known to benefit people with chronic pain and under controlled prescribing and specific dosing schedules, may be safer than opioids for chronic pain management. Notably, states with legalization of marijuana have up to 25% fewer opioid-related deaths.

In the past, I have prescribed oral Marinol (marijuana) to AIDS or cancer patients in order to decrease nausea or improve appetite; however, like most physicians, I lack prescribing privileges to provide marijuana for pain. I have known several patients to augment pain medications with marijuana for improved symptom relief. This practice, of course, is against medical advice and is highly illegal. In chronic opiod users, THC is easily detected in routine urine drug screens and its detection may discourage prescribing physicians to continue opiod management. Many physicians concerns revolve around side effects of concomitant marijuana use with prescribed pain medications including heart-related complications. In addition, many chronic pain patients suffer depression and THC is associated with worsening anxiety, depression and other underlying psychiatric disorders.

We have a lot to learn from Colorado’s legalization of marijuana. As a physician, I have many concerns with uncontrolled “over the counter” marijuana use. Sure, it is “natural”, but so is tobacco; “natural” does not mean that it is necessarily good. Perhaps in the future, under controlled circumstances, THC could be made carefully manufactured and made more easily prescribed under Food and Drug Administration’s (FDA) close monitoring of concentration and dosing.

Truly, marijuana legalization is a highly controversial subject in many social arenas. If so many people use marijuana to manage pain, then the medical community needs to do a better job of finding treatment solutions. For now, I will remain a passive observer with an open eye of interest looking over the horizon.

Don’t sit.Get up and move around. Attach your computer to a treadmill or invest in an upright computer. Your sedentary job position is not only putting you at risk for diabetes, but may increase your risk for heart disease, diabetes, cancer and premature death. Important research information that could extend your life was released this month from the Annals of Internal Medicine.

The solution to a sedentary job is not simply to race to the gym after work. Vigorous exercise outside of an 8-10 hour sedentary work day is definitely beneficial, butis not the complete solution to maintaining a healthy body. Prolonged sitting is downright (Texas term…) bad!

According to this most recent review, people averaging greater than 11 hours of work per day may have up to a 67% increased risk of dying from heart disease.Working between 10 and 11 hours daily may increase risk of heart-related illness or death up to 45%. Are you getting up out of your chair yet?

There are several standing computer desks available and several advantages to longer standing times in the work place. Standing may burn up to 50% more energy according to an informal study set up by the British Broadcasting Corporation (BBC) and a physician partner.Compared to sitting, standing may burn up to 50 more calories per hour. Standing for up to three hours a day for five days, you could burn approximately 750 additional calories in a work week. Even more amazing is that over the course of a year, this could add up to 30,000 calories or 8 pounds lost. Getting the idea yet?

With prolonged standing, be sure to stand on a comfortable surface such as a gel pad and maintain good posture so to avoid back and neck discomfort.Alternating sitting and standing is a good idea to healthy longevity. When at work, just think “out of the box” like a Jack-in-the-box!

Moms have all sorts of home remedies and most of the time they work! One of many unwritten rules at my clinic is “Mom is always right…” because she knows her kids well and also knows what works best to manage their symptoms. Over the last several years I have heard of all kinds of mom remedies and using ginger for nausea has been one of the most effective mother-instructed therapies. How does Momma know best? I am not sure, but researchers support her ginger Rx success.

Pregnancy-associated nausea symptoms can be reduced by ginger according to several studies. Many of my pregnant patients have used this natural remedy with great success.

In addition, there are several studies using natural ginger as an effective adjuvant at decreasing postoperative nausea. One of the more difficult symptoms to overcome after surgery, nausea is sometimes more debilitating than the postoperative pain.Patients using ginger capsules required less anti-nausea medication, which helped decrease the side effects of these sedating medications.

Physicians commonly receive phone calls for nausea associated with pain medications. For drug-induced nausea and vomiting, ginger showed promising effects in preventing those unwanted symptoms, or was shown to be an effective add-on therapy to prescription anti-nausea medication.

Ginger has many other physical benefits and has been shown to possess chemical properties that might contribute to stomach wall protection. WebMD lists ginger among its nausea remedies but before buying any commercially prepared capsules, I would consult your doctor to be certain there are no drug interactions or manufacture concerns.

Most studies used ginger capsules, but you can get a dose of ginger from ginger tea, ginger lollipops, or ginger ale. If choosing soda, be certain it is a natural ginger ale made from ginger root rather than artificial flavoring. Even Fido may benefit from ginger for car sickness according to veterinarians . I have known several to suggest ginger snaps (a tasty option).

Ginger aromatherapy may be beneficial (refer to my recent blog on frankincense). Aromatherapy is promising as an inexpensive, noninvasive treatment for nausea that can be administered and controlled by patients as needed. Hopefully, there is more research in the works.

For many people, this information may not seem new and your mom may have trained you to use ginger for your ailments. Therefore this blog boils down to one important point: listen to your mother because she is probably right (but feel free to use your doctor for a second opinion).

**Blog written with the assistance of Dr Courtney Campbell PhD, medical student Vanderbilt University School of Medicine.

My brother in Alaska would disagree that this cold front is truly “cold”; but, to us Texans, it is “downright chilly”. But, do not believe that this cold front is all that bad.Cold weather exposure may increase brown fat according to a recent study from the University of California, Berkeley. Unlike our predominant white fat, brown fat increases our ability to burn calories. Hmmm…maybe this cold weather is not so bad.

Researchers found that cold exposure increases the levels of certain proteins that contribute to the formation of brown fat. Mice with elevated levels of this protein (Zfp516) gained 30% less weight when fed high fat diets compared to normal mice.

Brown fat is the “heat producing, calorie-burning” fat predominant in babies. It helps infants to maintain normal body temperature. As we get older, brown fat is no longer as necessary and tends to disappear. But more studies are being conducted to study the effects of cool weather on brown fat production.

Before you decide to run outside naked or take the polar bear ice plunge, it is important to know that not all mice success stories translate to positive human results. However, a study cited in the Harvard Letter (January 2010), found 23 of 24 volunteers exposed to 61 degree cool temperatures were able to activate brown fat. Perhaps scientists will develop medication using the specific brown fat protein to increase our levels of brown fat.

Just be cautious before you plan to include cold weather exposure into your 2015 weight loss program. Extended cold weather experiences may not be healthy for individuals with underlying medical conditions such as heart disease or diabetes.

As for me, I will keep my thermostat on “warm” during these cool months and I have no plans to purposefully activate my brown fat. Instead, I plan to stay comfortable during this most recent cold front.

I have had the same breakfast meal for the last 30 years. No kidding. Ever since college, I have enjoyed my cup of coffee yogurt in the morning. Heck, sometimes I even throw on some whipped crème (people add crème to their coffee, right?).

Today, I can be proud of my healthy habit (minus the whipped crème) and be confident that continuing my daily yogurt consumption will be beneficial in the long run. According to a recent study, higher intake of yogurt was associated with a lower risk of type 2 diabetes. In addition, the study found that there was a dose-response relationship with yogurt. With more servings of daily yogurt, the risk of diabetes dropped even more.

One daily serving (defined as only 2 tablespoons or 28grams) was linked to an 18% reduction in type 2 diabetes risk. There are approximately 150 grams (5.3 ounces) in several Dannon yogurt packages. Therefore this study from Biomedcentral Medicine December 2014, suggests a healthy incremental benefit from eating daily yogurt packets.

The study, conducted by a team out of Harvard School of Public Health, reviewed data from three larger studies that had collected information on dairy food intake from over 195,000 health professionals. Over several decades time, approximately 15,000 participants developed type 2 diabetes. That is a significant number of diabetics.

According to the Centers for Disease Control and Prevention (CDC), approximately 9.3% of Americans have diabetes (approximately 29 million people). Any positive impact on these numbers could significantly impact quality of life and health care costs. The average annual cost of healthcare for people with diabetes (2009) was $11,700 (CDC.gov). For diabetics with kidney complications, the average cost was closer to $20,000.

Most all Americans are searching for cost-cutting health care opportunities. However if you are not a yogurt fan, this blog may seem less important for you. Unfortunately, researchers found no association with other dairy foods and reductions of type 2 diabetes risks. In other words, ice cream is not on the healthy list. For me, this investigation reinforces the fact that my 30-year morning coffee yogurt intake is my daily dose of healthy indulgence. I hope you find yours.

This past Friday, a 50-pound lighter Santa showed up healthier and jollier at his annual physical at Baylor University Medical Center and Our Children’s House Baylor. Less of a bowl full of jelly, this Santa was still full of life and laughter. I think you will will enjoy his real-life story.

I am so proud of Santa! Happy Holidays to you all! I hope you enjoy my rendition of Santa’s physical:

You know the song. Famously performed by Elvis Presley, the melancholy seeps thru the swooning melody as he pipes about being lonesome at Christmas. It’s a “Blue, blue, blue…Christmas” and it makes me sad. But not for long, because this time of year is joyous…or it should be a happy time; that is, unless you suffer from holiday blues.

We commonly see patients this time of year with stress and anxiety that percolate around the holidays. Relatives (wanted and unwanted) come to visit and we vigorously prepare for comfortable accommodations with our exhaustive decorating and culinary artistry. It is the time of year that family gift expectations seem to amplify financial stresses. Shortened daylight hours darken our mood and may compound general seasonal apathy.

According to Brandi Sinclair LPC-S of Heritage Counseling and Consulting, the holiday blues is a seasonal event that lasts less than 2 weeks. “It occurs due to unrealistic expectations that we should feel overly happy or overly merry.” Brandi’s experience reflects an increase in demand for couples counseling because difficulties in relationships become more evident during the holidays. According to Brandi, existing issues seem exaggerated this time of year.

Here is some professional counseling advice Brandi provides to her patients and clients:

Do something for yourself. Give to yourself. Get a pedicure or a hot bath or a nice long walk according to Brandi Sinclair.

Recognize that you are not the only alone in your holiday blues. Many other people are struggling as well.

Keep it in perspective. This too shall pass. Every holiday can’t be perfect. Christmas comes again next year!

If your sad mood lasts beyond the holiday season, then it is very important to seek professional help. According to the Centers for Disease Control and Prevention (CDC), 1 in 10 adults suffer from major depression. Be sure to contact your medical provider if you continue to experience sadness, irritability, sleeplessness and/or hopelessness.

Your holiday experience may not be the season for continuous jolliness, but it should be a time of peace and rest. I hope you experience both this time of year!

One of the leading flu viruses this year has become mutant ninja flu. Minus the half-back shell and face mask, the flu is clever and could be quick to cover our city. Despite being judiciously cautious and receiving your flu shot, you are still at risk for contracting this mutant flu strain. There is a drifter amongst us. It’s name: The 2014-2015 influenza H3N2 virus.

According to the Centers for Disease Control and Prevention (CDC), approximately 52% of the H3N2 influenza A virus has “drifted” which means this years flu shot may not be completely protective. Get ready for a tough season because as of November, up to 91% of reported flu cases were influenza A. As a reminder, flu symptoms include high fever, chills, muscle aches, fatigue, nausea, vomiting, cough and congestion.

From the CDC: “Past seasons in which the influenza A (H3N2) have predominated, higher overall and age-specific hospitalization rates and more mortality have been observed, especially among older people, very young children and persons with certain chronic medical conditions compared with seasons during which influenza A (H1N1) or influenza B viruses have predominated.”

Before my anti-flu shot friends get fired up, let me remind you, that arming yourself with this year’s flu shot does provide some protection from mutated flu viruses. In addition, there are several other flu strains that are covered by this year’s flu vaccine.

The CDC reminds us to get a flu shot, which will provide your shield when confronted or afflicted with the flu. Reach out early to your medical provider and gather your anti-flu weapon. When taken within 24-48 hours of symptoms, prescription medicine, Tamiflu can reduce the duration and severity of the flu virus. If you are exposed but not yet sickened by the flu, then Tamiflu could prevent flu illness. Because we now know about this flu “drifter”, you may need preventative medication whether or not you received the flu shot.

Because of this mutant flu strain, think like a super hero mutant ninja turtle. Suit up with your flu shot, get to your medical provider should you need medication weaponry, and (“cowabunga!”) get better fast!